Reliability of Vocal Self-assessment Tools in Individuals With Vocal Complaints Applied Using a Digital Platform and In-person.

OBJECTIVE: To verify the reliability of vocal self-assessment tools in individuals with vocal complaints using a digital platform and in-person. METHODS: Data from 50 Brazilian adults with vocal complaints were collected. The participants answered the Voice Symptoms Scale (VoiSS), the Voice Handicap Index - 10 (VHI-10), and questions regarding personal information and their general health. The data collection occurred in two moments, within a period of 2-14 days, with time variation between participants, and always in the same collection order: 1. using a digital platform (Google Forms); 2. In-person. The data were analyzed descriptively and inferentially using the SPSS 25.0 software and the Wilcoxon Test. RESULTS: The self-perception of vocal symptoms in the Emotional factors for women presented a statistical difference between the digital platform and the in-person response (P = 0.029); higher scores were observed when answers were given in-person compared to using a digital platform. CONCLUSION: Overall, the participants perceived their voice symptoms and voice handicap similarly when answers were given using a digital platform and in-person. The Emotion voice symptoms in women were the only exception, although remaining deviated; however, the perception of the symptoms may have been attenuated during the in-person care.

Brazilian Dysphonia Screening Tool (Br-DST): An Instrument Based on Voice Self-Assessment Items.

OBJECTIVE: To propose a short instrument for the screening of dysphonia in the Brazilian population through the investigation of traditional voice self-assessment instrument items. METHODS: We analyzed the medical records of 139 individuals with an average age of 37.4 years and a minimum and maximum age of 18 and 77 years, respectively. The participants were classified as dysphonic (D) or non-dysphonic (ND) according to an analysis of the combination of vocal complaints and laryngological reports. Responses to the items of the following self-assessment instruments were collected: the Questionário de Qualidade de Vida em Voz - QVV (Voice-Related Quality of Life - V-RQOL), the Índice de Desvantagem Vocal - IDV (Voice Handicap Index - VHI) and the Escala de Sintomas Vocais - ESV (Voice Symptom Scale - VoiSS). These items were analyzed regarding their predictive capacities for dysphonia through logistic regression models. RESULTS: The model containing items of the QVV was not observed to be valid. The model for the IDV produced a set of three items (10, 13, and 14), and the ESV model showed two items (4 and 20) to be significant. A Global model combining the previous models shows that items I feel as though I have to strain to produce voice from the IDV and "Is your voice hoarse?" from the ESV are the most significant in the classification of the presence of dysphonia. This decision-making model was considered the most efficient to identify the dysphonia, with the highest level of accuracy compared to the other models investigated (83.4%). CONCLUSION: Dysphonia screening can be performed using a simple, rapid protocol with a high-efficiency index that includes two items taken from traditional voice self-assessment instruments.

Impactos da percepção comunicacional e da timidez autorreferidos na avaliação ao falar em público de estudantes universitários / Impacts of self-reported communication perception and shyness on the public speaking assessment of university students

RESUMO Objetivo comparar a autoavaliação ao falar em público, por meio da Escala para Autoavaliação ao Falar em Público, com a percepção comunicacional e timidez autorreferidos, de estudantes universitários. Método tratou-se de um estudo observacional transversal prospectivo. Foram convidados a participar deste estudo, estudantes universitários do Brasil de diferentes áreas de conhecimento, sendo incluídos os que assentiram em participar. Os participantes receberam convite eletrônico e preencheram um formulário elaborado na plataforma Google Forms que continha questões sociodemográficas, sobre autopercepção como bom falante, sobre facilidade para se expressar, sobre timidez, e a Escala para Autoavaliação ao Falar em Público. Foram comparadas as médias da Escala de Autoavaliação ao Falar em Público com a autopercepção como bom falante, com a facilidade para se expressar e com a timidez. Resultados os participantes que se consideravam bons comunicadores, os que acreditavam ter facilidade para se expressar e os que não eram tímidos apresentaram melhor autopercepção sobre as suas habilidades de fala em público. Conclusão a autopercepção comunicacional positiva, bem como a autopercepção de menor timidez estão relacionadas a uma autoavaliação mais favorável em relação a apresentações em público.

ABSTRACT Purpose To compare self-assessment when speaking in public, using the Self-Statements During Public Speaking scale, with the communicational perception and self-reported shyness of university students. Methods This was a prospective cross-sectional observational study. University students from different areas of knowledge in Brazil were invited to participate in this study. Those who agreed to participate were included. Participants received an electronic invitation and filled out a form created on the Google Forms platform that contained sociodemographic questions, on self-perception as a good speaker, on ease of expression, on shyness, and the Self-Statements During Public Speaking scale. The means of the Self-Statements During Public Speaking scale were compared with the self-perception as a good speaker, the ease of expressing oneself, and shyness. Results Participants who considered themselves to be good communicators, those who believed they had an ease to express themselves, and those who were not shy had better self-perception of their public speaking skills. Conclusion positive communicational self-perception, as well as less shyness self-perception, are related to a more favorable self-assessment in relation to public presentations.

Autoavaliação de sintomas relacionados à voz em indivíduos com câncer de tireoide antes, imediatamente após e no pós-operatório tardio de tireoidectomia / Self-assessment of voice-related symptoms in individuals with thyroid cancer before, immediately after, and in the late postoperative period of thyroidectomy

RESUMO Objetivo Verificar autopercepção de sintomas vocais, de fadiga vocal e relacionados à tireoidectomia em indivíduos com câncer de tireoide, nos momentos pré-operatório, pós-operatório imediato e pós-operatório tardio, e analisar a influência do gênero. Métodos Trata-se de um estudo de intervenção antes e após com 20 indivíduos com câncer de tireoide, média de 46 anos de idade, avaliados em três momentos: pré-cirurgia (M1), imediatamente após cirurgia (M2) e no pós-operatório tardio (M3) da tireoidectomia. Os indivíduos responderam aos instrumentos Escala de Sintomas Vocais, Índice de Fadiga Vocal e Thyroidectomy-Related Voice and Symptom Questionnaire. Os dados foram analisados ​​de forma descritiva e inferencial. Resultados Na autoavaliação de sintomas vocais físicos e orofaringolaríngeos relacionados à tireoidectomia, o M3 apresentou valores estatisticamente menores que o M1 (p=0,006 e p=0,028, respectivamente) e o M2 (p<0,001 e p=0,004, respectivamente). Para os sintomas totais (p=0,001) e vocais (p=0,001) relacionados à tireoidectomia, os valores do M3 foram significativamente menores que os do M2. Na autoavaliação de sintomas vocais dos domínios total e limitação, o M1 (p<0,001; p<0,001) e o M3 (p=0,013; p=0,001) apresentaram valores significativamente menores que o M2. Indivíduos do gênero masculino apresentaram percepção de sintomas de fadiga no domínio fadiga e limitação vocal (p=0,035) e percepção de sintomas relacionados à tireoidectomia nos domínios total (p=0,044) e sintomas vocais (p=0,012) significativamente menores do que os do gênero feminino, independentemente do momento. Conclusão Sintomas vocais físicos e relacionados à tireoidectomia diminuem no pós-operatório tardio; sintomas vocais totais e limitação aumentam no pós-operatório imediato e diminuem no tardio. Mulheres têm maior percepção de fadiga e limitação vocal e de sintomas totais e vocais relacionados à tireoidectomia.

ABSTRACT Purpose To verify the self-perception of symptoms and vocal fatigue related to thyroidectomy in individuals with thyroid cancer in the pre, immediate post and late post-operative moments, and to analyze the influence of gender. Methods Intervention study before and after with 20 individuals, mean age 46 years, evaluated before surgery (M1), immediately after surgery (M2) and in the late postoperative period (M3) of thyroidectomy. Individuals answered the instruments: Voice Symptoms Scale, Vocal Fatigue Index and Thyroidectomy-Related Voice and Symptom Questionnaire. Data were analyzed descriptively and inferentially. Results In self-assessment of vocal symptoms of the total domains and limitation, M1 (p<0.001; p<0.001, respectively) and M3 (p=0.013; p=0.001, respectively) had significantly lower values than the M2. For the physical domain of self-assessment of vocal symptoms, the M3 showed statistically lower values than the M1 (p=0.006) and the M2 (p<0.001) assessments. Depending on the moment, the oropharyngolaryngeal symptoms in M3 had significantly lower values ​​than M2 (p=0.004) and M1 (p=0.028). Male scores were significantly lower than female scores in the self-assessment of fatigue symptoms in the fatigue and vocal limitation domain (p=0.035), regardless of the time of assessment. Conclusion Physical vocal symptoms and thyroidectomy-related symptoms decrease in the late postoperative period; total vocal symptoms and limitation increasing in the immediate postoperative period and decrease in the late postoperative period. Women have a higher perception of vocal fatigue and limitation, and of total and vocal symptoms related to thyroidectomy.

Impacts of self-reported communication perception and shyness on the public speaking assessment of university students. / Impactos da percepção comunicacional e da timidez autorreferidos na avaliação ao falar em público de estudantes universitários.

PURPOSE: To compare self-assessment when speaking in public, using the Self-Statements During Public Speaking scale, with the communicational perception and self-reported shyness of university students. METHODS: This was a prospective cross-sectional observational study. University students from different areas of knowledge in Brazil were invited to participate in this study. Those who agreed to participate were included. Participants received an electronic invitation and filled out a form created on the Google Forms platform that contained sociodemographic questions, on self-perception as a good speaker, on ease of expression, on shyness, and the Self-Statements During Public Speaking scale. The means of the Self-Statements During Public Speaking scale were compared with the self-perception as a good speaker, the ease of expressing oneself, and shyness. RESULTS: Participants who considered themselves to be good communicators, those who believed they had an ease to express themselves, and those who were not shy had better self-perception of their public speaking skills. CONCLUSION: positive communicational self-perception, as well as less shyness self-perception, are related to a more favorable self-assessment in relation to public presentations.

OBJETIVO: comparar a autoavaliação ao falar em público, por meio da Escala para Autoavaliação ao Falar em Público, com a percepção comunicacional e timidez autorreferidos, de estudantes universitários. MÉTODO: tratou-se de um estudo observacional transversal prospectivo. Foram convidados a participar deste estudo, estudantes universitários do Brasil de diferentes áreas de conhecimento, sendo incluídos os que assentiram em participar. Os participantes receberam convite eletrônico e preencheram um formulário elaborado na plataforma Google Forms que continha questões sociodemográficas, sobre autopercepção como bom falante, sobre facilidade para se expressar, sobre timidez, e a Escala para Autoavaliação ao Falar em Público. Foram comparadas as médias da Escala de Autoavaliação ao Falar em Público com a autopercepção como bom falante, com a facilidade para se expressar e com a timidez. RESULTADOS: os participantes que se consideravam bons comunicadores, os que acreditavam ter facilidade para se expressar e os que não eram tímidos apresentaram melhor autopercepção sobre as suas habilidades de fala em público. CONCLUSÃO: a autopercepção comunicacional positiva, bem como a autopercepção de menor timidez estão relacionadas a uma autoavaliação mais favorável em relação a apresentações em público.

Validation of the Self-assessment of Communication Competence (SACCom) in Brazilian Portuguese Through Item Response Theory.

OBJECTIVE: To evaluate the validity of the Self-assessment of Communication Competence - SACCom by analyzing the communication competency of adult individuals using the item response theory (IRT). METHODS: Overall, 778 individuals who responded to SACCom participated in this study. The initial version consisted of 20 polytomous items regarding communication skills. Polytomous answer keys to each item were ordered as follows: 1 - no, 2 - more or less, and 3 - yes. The IRT and the gradual response model, a 2-parameter logistic model for polytomous items, were used for validation. RESULTS: Due to problems in the preliminary analysis using the item characteristic curve (ICC), answer keys to SACCom items were reorganized in an ordinal dichotomous way. Response 1 was coded as 0 - no, while responses 2 and 3 were coded as 1 - yes. Item 9 of the ICC was problematic and did not add information to the instrument; hence, this item was excluded. SACCom, in its dichotomous format with 19 items, was unidimensional according to the eigenvalues graph and tetrachoric correlation analysis. The Cronbach's alpha coefficient showed an internal consistency value of 0.711. All item-total correlations were greater than 0.284. Item discrimination parameters ranged from a = 0.563 to a = 1.505, and the difficulty of the items ranged between b = -2.725 and b = 0.612. The likelihood ratio test showed that the model without restrictions best fit the data. ICC gleaned more information for individuals with lower communication skills. CONCLUSION: The 19-item, dichotomous SACCom is valid for the analysis of communication skills according to the IRT.

Reducing the GAP between science and clinic: lessons from academia and professional practice - part A: perceptual-auditory judgment of vocal quality, acoustic vocal signal analysis and voice self-assessment. / Reduzindo o GAP entre a ciência e a clínica: lições da academia e da prática profissional ­ parte A: julgamento perceptivo-auditivo da qualidade vocal, análise acústica do sinal vocal e autoavaliação em voz.

During the XXVIII Brazilian Congress of SBFa, 24 specialists met and, from a leading position on scientific research as a tool for connecting laboratory and clinic, five fronts of knowledge of the voice specialty were discussed as following: Perceptual-auditory judgment of vocal quality; 2. Acoustic analysis of the vocal signal; 3. Voice self-assessment; 4. Traditional techniques of therapy; 5. Modern techniques of electrostimulation and photobiomodulation (PBMT) in voice. Part "a" of this publication was associated with the consolidation of the analyses of the first three aspects. The trend in the perceptual-auditory judgment of vocal quality was related to the use of standard protocols. The acoustic evaluation of the vocal signal is accessible and can be done descriptively or by extraction of parameters, thus preferring multiparametric measures. Finally, the analysis of the individual himself closes this triad of voice documentation, which will be the basis for the conclusion of the evaluation, reference for monitoring progress, and evaluation of treatment results.

No XXVIII Congresso Brasileiro da SBFa, 24 especialistas reuniram-se e, a partir de um posicionamento condutor sobre pesquisa científica como ferramenta de conexão entre laboratório e clínica, cinco frentes de conhecimento da especialidade de voz foram discutidas: 1. Julgamento perceptivo-auditivo da qualidade vocal; 2. Análise acústica do sinal vocal; 3. Autoavaliação em voz; 4. Técnicas tradicionais de terapia; 5. Técnicas modernas de eletroestimulação e fotobiomodulação em voz. A parte "a" desta publicação é a consolidação das análises dos três primeiros aspectos. A tendência no julgamento perceptivo-auditivo da qualidade vocal é o uso de protocolos padrão. A avaliação acústica do sinal vocal é acessível e pode ser feita de modo descritivo ou por extração de parâmetros, preferindo-se medidas multiparamétricas. Finalmente, a análise do próprio indivíduo fecha essa tríade de documentação fonoaudiológica, que será base para a conclusão da avaliação, referência para monitoramento do progresso e avaliação de resultado de tratamento.

Clinical Parameters of the Speech-Language Pathology Assessment of the Chronic Cough: A Scoping Review.

OBJECTIVE: to map the clinical parameters used in the speech-language pathology assessment of the chronic cough. METHODS: a scoping review was performed to answer the clinical question: "What are the clinical parameters included in the speech-language pathology assessment of patients with chronic cough?" Evidence was searched by electronic and manual search. The electronic search included: MEDLINE, Cochrane Library, EMBASE, Web of Science, SCOPUS, and LILACS. Each database had a specific search strategy. The manual search included Journal of Voice, Chest, and Thorax, Brazilian Library of Theses and Dissertations, Open Grey, and Clinical Trials, in addition to scanning the references of the included studies. The extracted data considered information regarding the publication, sample, assessment, and measures used when assessing chronic cough. RESULTS: the electronic search found 289 studies; the manual search found 1036 studies; 12 were selected for the present study. The most used assessments were: self-assessment (75%), aerodynamic analysis (66.67%), the perceptual auditory judgment of the voice quality (58.33%), acoustic analysis of the voice (41.67%), cough frequency, and cough threshold (41.67%) and electroglottography (25%). CONCLUSIONS: the subjective instruments were used more frequently, while specific objective instruments, which are recent, were used less frequently. Complementary assessments such as vocal assessment, have been frequently used, also, with no other parameter. A lack of homogeneity was identified in the speech-language pathology assessment and measures of patients with chronic cough, thus, the comparison among studies and clinical analysis is difficult.

Percepção de queixa vocal e autoavaliação do impacto de um problema de voz em atores profissionais de teatro / Perceived vocal complaint and self- assessment of the vocal problem impact in professional theater actors

RESUMO Objetivo investigar a ocorrência de queixa vocal autorreferida no uso profissional da voz em atores profissionais de teatro; correlacionar presença de queixa vocal com três protocolos de autoavaliação do impacto de uma alteração vocal: Escala de Sintomas Vocais (ESV), Escala de Desconforto do Trato Vocal (EDTV) e Índice de Desvantagem Vocal -10 (IDV-10); verificar quais protocolos são mais robustos à detecção do impacto de possível disfonia nessa população. Métodos Participaram 75 atores profissionais de teatro, ambos os gêneros, 18 a 64 anos. Os atores informaram a presença ou ausência de queixa vocal e responderam a três protocolos de autoavaliação: Escala de Sintomas Vocais (ESV), Escala de Desconforto do Trato Vocal (EDTV) e Índice de Desvantagem Vocal-10 (IDV-10). Resultados constatou-se que 25% dos atores apresentaram queixa vocal. O grupo com queixa (GCQ) apresentou maior número de sintomas vocais e maior frequência e intensidade de desconforto de trato vocal, quando comparado ao grupo sem queixa (GSQ). IDV-10 não identificou desvantagem vocal nos grupos. No GCQ, houve correlação forte entre ESV e IDV-10 e correlação muito forte entre os escores de frequência e intensidade da EDTV. No GSQ, houve correlação moderada entre ESV e EDTV, ESV e IDV-10 e correlação muito forte entre os escores de frequência e intensidade da EDTV. Conclusão neste estudo, 25% dos atores profissionais de teatro apresentaram queixa vocal. A correlação entre a queixa vocal e os protocolos foi positiva e variou de moderada à forte. No GCQ, a ESV e a EDTV foram instrumentos mais robustos na detecção do impacto de uma possível disfonia.

ABSTRACT Purpose To investigate the occurrence of self-reported vocal complaints in the professional use of the voice in professional theater actors; analyze the correlation between the presence of vocal complaint and three self-assessment protocols of the vocal problem impact; The Voice Symptom Scale (VoiSS), the Vocal Tract Discomfort (VTD) scale and the Voice Handicap Index -10 (VHI -10); verify the most robust protocols to identify dysphonia in this population. Methods The participants were 75 professional theater actors, men and women, between 18 and 64 years old. They answered to a questioner informing presence or absence of vocal complaint and to three self-assessment protocols: VoiSS, VTD and VHI-10. Results 25% of the actors presented vocal complaints. The group with vocal complaint (GwVC) had more voice symptoms and higher frequency and intensity of vocal tract discomfort than the group with no vocal complaint (GnVC). No group presented voice handicap considering the VHI-10 and a very high correlation between the VTD frequency and intensity scores. The GnVC presented moderate correlation between the VoiSS and the VTD, moderate correlation between the VoiSS and the VHI-10 and, a very high correlation between the VTD frequency and intensity scores. Conclusion In this study, 25% of professional theater actors presented vocal complaints. The correlation between vocal complaints and protocols was positive and ranged from moderate to strong. The VoiSS and the VTD were more robust identify dysphonia in the GwVC.

Reduzindo o GAP entre a ciência e a clínica: lições da academia e da prática profissional - parte A: julgamento perceptivo-auditivo da qualidade vocal, análise acústica do sinal vocal e autoavaliação em voz / Reducing the GAP between science and clinic: lessons from academia and professional practice - part A: perceptual-auditory judgment of vocal quality, acoustic vocal signal analysis and voice self-assessment

RESUMO No XXVIII Congresso Brasileiro da SBFa, 24 especialistas reuniram-se e, a partir de um posicionamento condutor sobre pesquisa científica como ferramenta de conexão entre laboratório e clínica, cinco frentes de conhecimento da especialidade de voz foram discutidas: 1. Julgamento perceptivo-auditivo da qualidade vocal; 2. Análise acústica do sinal vocal; 3. Autoavaliação em voz; 4. Técnicas tradicionais de terapia; 5. Técnicas modernas de eletroestimulação e fotobiomodulação em voz. A parte "a" desta publicação é a consolidação das análises dos três primeiros aspectos. A tendência no julgamento perceptivo-auditivo da qualidade vocal é o uso de protocolos padrão. A avaliação acústica do sinal vocal é acessível e pode ser feita de modo descritivo ou por extração de parâmetros, preferindo-se medidas multiparamétricas. Finalmente, a análise do próprio indivíduo fecha essa tríade de documentação fonoaudiológica, que será base para a conclusão da avaliação, referência para monitoramento do progresso e avaliação de resultado de tratamento.

ABSTRACT During the XXVIII Brazilian Congress of SBFa, 24 specialists met and, from a leading position on scientific research as a tool for connecting laboratory and clinic, five fronts of knowledge of the voice specialty were discussed as following: Perceptual-auditory judgment of vocal quality; 2. Acoustic analysis of the vocal signal; 3. Voice self-assessment; 4. Traditional techniques of therapy; 5. Modern techniques of electrostimulation and photobiomodulation (PBMT) in voice. Part "a" of this publication was associated with the consolidation of the analyses of the first three aspects. The trend in the perceptual-auditory judgment of vocal quality was related to the use of standard protocols. The acoustic evaluation of the vocal signal is accessible and can be done descriptively or by extraction of parameters, thus preferring multiparametric measures. Finally, the analysis of the individual himself closes this triad of voice documentation, which will be the basis for the conclusion of the evaluation, reference for monitoring progress, and evaluation of treatment results.

Auditory-perceptual Assessment of Healthy and Disordered Voices Using the Voice Deviation Scale.

OBJECTIVE: This study aims to (1) determine the cut-off values of the Global Severity of vocal deviation on the Visual Analog Scale (VAS) from the numerical scale ratings, and (2) identify the cut-off values according to different degrees of vocal deviation used by Voice-Specialized Speech-Language Pathologists (SLP). STUDY DESIGN: Prospective study. METHODS: The auditory-perceptual assessment was performed by four SLPs using two protocols with different scales: the VAS and the 4-point numerical scale. Among the 211 voices analyzed, 147 corresponded to female participants, and 64 corresponded to males, plus 20% repeated voice samples. Participants were between 19 and 60 years. All of them were asked to count from 1 to 10 and were recorded in a sound-proof booth. For both protocols, the judges scored the overall severity. One SLP was excluded from the analysis due to inconsistency during the perceptual assessment. RESULTS: For normal voice and mild deviations, overall severity cut-off score on the VAS was 21. For mild-moderate deviations, the cut-off was 55; and 81 points for moderate and severe deviations. The Area Under the Curve values correspond to 0.725, 0.905 and 0.851, respectively. CONCLUSIONS: Our results suggest that the VAS is a good instrument to be used during voice assessment performed by Chilean SLPs. However, it evidences possible differences in voice analysis perception with other cut-off scores performed in other countries, which can be compared to future studies.

Processo de validação de instrumentos de autoavaliação da voz no Brasil / Validation process of voice self-assessment instruments in Brazil

RESUMO Objetivo caracterizar e refletir sobre o processo de equivalência cultural e/ou validação de instrumentos de autoavaliação vocal traduzidos e adaptados para o português brasileiro, utilizados na prática clínica e em pesquisas científicas. Estratégia de pesquisa Buscas realizadas nas bases de dados: SciELO, LILACS, PubMed e The Cochrane Library. Critérios de seleção estudos selecionados quanto à presença dos descritores citados em seu título, resumo ou lista de descritores; artigos de validação de instrumento de autoavaliação em voz, ou com o objetivo de realizar equivalência cultural; direcionados à população brasileira; estudos originais com amostra de seres humanos, independentemente da idade do ciclo vital, tipo de disfonia ou sintomas vocais. Resultados nove artigos selecionados. Qualidade de vida em voz e desvantagem vocal foram os construtos mais abordados. A maioria das validações ocorreu na Região Sudeste do Brasil. A maior parte dos escores dos instrumentos foi calculada por somatório simples das respostas dos participantes nos itens; pontos de corte nem sempre foram apresentados. Os domínios dos instrumentos, bem como os itens que os compunham, foram mantidos conforme apresentado no instrumento em sua língua original. A estatística mais comum para análise dos instrumentos foi o coeficiente Alfa de Crombach. Conclusão os construtos mais abordados nos artigos selecionados foram qualidade de vida em voz e índice de desvantagem vocal. Os instrumentos foram considerados válidos e sensíveis para autoavaliação vocal, mesmo quando não consideradas as etapas propostas internacionalmente para validação de instrumentos em saúde.

ABSTRACT Objective to characterize and reflect on the process of cultural equivalence and/or validation of vocal self-assessment instruments translated and adapted to the Brazilian Portuguese, used in clinical practice and scientific research. Research strategy The search of articles was carried out in the following databases: SciELO, LILACS, PubMed and "The Cochrane Library". Selection criteria The studies were selected regarding the presence of the descriptors cited in their title, abstract or in the list of descriptors; validation articles of a self-assessment instrument in voice or with the objective of performing cultural equivalence; to be directed to the Brazilian population; original studies with a sample of human beings; regardless of the age of the life cycle, type of dysphonia or vocal symptoms. Results Nine articles were selected. Quality of life in voice and vocal handicap were the most addressed constructs. Most validations occurred in the Southeast region of Brazil. The scores of the instruments is calculated by a simple sum of the answers given by the participants in the items; cutoff points are not always presented. The domains of the instruments, as well as the items that compose them, were maintained as presented in the instrument in its original. The most common statistic for instrument analysis was Cronbach's Alpha coefficient. Conclusion The constructs most addressed in the selected articles were quality of life in voice and vocal handicap index. The instruments were considered valid and sensitive for vocal self-assessment, even not considering the international proposals for validation of health instruments.

Self-assessment of communication resources used by sales representatives and its relation with sales performance. / Autoavaliação dos recursos comunicativos por representantes comerciais e sua relação com o desempenho em vendas.

PURPOSE: To analyze the self-assessment of communication resources used by sales representatives and its relation with their sales performance. METHODS: The study counted with 55 sales representatives, 46 men and 9 women, between 24 and 56 years old. In the first phase of the study, participants answered questions related to identification data, self-assessment protocols of vocal behavior and communicative resources; besides that, they were asked to select the positive and negative communication resources of their own speech during the sales. In the next phase, the participants were divided into two groups according to their sales performance: Group A (GA), individuals with better sales performance and Group B (GB), individuals with worst sales performance. The data were statistically analyzed. RESULTS: Regarding the vocal behavior self-assessment, the sales representatives considered their voice quality as normal, their vocal pitch, loudness and speech rate as regular and as having an expressive voice. Regarding the communicative behavior, there was low presence of regionalism, use of gesture and use of other support resources during the sales; contrarily, there was high occurrence of precise articulation of speech sounds, visual contact, lack of inhibition to talk, time monitoring and objectivity of the speech. CONCLUSION: The sales representatives' self-assessment was positive for the objectivity of the speech, knowledge of the subject and use of proper vocabulary; it was negative for, lack of subject domain, criticism and prejudgment, and improper vocabulary. The self-assessment was similar in GA and GB.

OBJETIVO: Analisar a autoavaliação dos recursos comunicativos utilizados por representantes comerciais e sua relação com o desempenho em vendas. MÉTODO: A amostra foi composta de 55 representantes comerciais, dos quais 46 eram homens e 9 eram mulheres, com idade entre 24 e 56 anos. Na primeira etapa, foi aplicado um protocolo com questões referentes aos dados de identificação, autoavaliação do comportamento vocal e dos recursos comunicativos e seleção de recursos comunicativos de influência positiva e negativa no seu próprio discurso na situação de venda. Na etapa seguinte, os participantes foram separados em dois grupos em função do desempenho em vendas: grupo A (GA), com melhor desempenho em vendas, e grupo B (GB), com pior desempenho em vendas. Tal divisão foi realizada de acordo com informações fornecidas pela empresa. Os resultados foram submetidos à análise estatística. RESULTADOS: Na autoavaliação do comportamento vocal, os representantes consideraram sua qualidade vocal normal, frequência, intensidade de voz e velocidade de fala regulares, além de voz expressiva. Com relação aos recursos comunicativos, houve baixa ocorrência de regionalismo, de uso de gestos e de recursos de apoio nas vendas e alta ocorrência de articulação precisa dos sons da fala, de contato visual, de desinibição na comunicação, de controle do tempo e de objetividade do discurso. CONCLUSÃO: Representantes de vendas autoavaliaram de forma positiva a objetividade no discurso, o domínio do assunto e o uso de vocabulário adequado e de forma negativa a falta de domínio do assunto, as críticas e os preconceitos e o uso de vocabulário inadequado. Os grupos A e B se autoavaliaram de forma semelhante.

Autoavaliação dos recursos comunicativos por representantes comerciais e sua relação com o desempenho em vendas / Self-assessment of communication resources used by sales representatives and its relation with sales performance

RESUMO Objetivo Analisar a autoavaliação dos recursos comunicativos utilizados por representantes comerciais e sua relação com o desempenho em vendas. Método A amostra foi composta de 55 representantes comerciais, dos quais 46 eram homens e 9 eram mulheres, com idade entre 24 e 56 anos. Na primeira etapa, foi aplicado um protocolo com questões referentes aos dados de identificação, autoavaliação do comportamento vocal e dos recursos comunicativos e seleção de recursos comunicativos de influência positiva e negativa no seu próprio discurso na situação de venda. Na etapa seguinte, os participantes foram separados em dois grupos em função do desempenho em vendas: grupo A (GA), com melhor desempenho em vendas, e grupo B (GB), com pior desempenho em vendas. Tal divisão foi realizada de acordo com informações fornecidas pela empresa. Os resultados foram submetidos à análise estatística. Resultados Na autoavaliação do comportamento vocal, os representantes consideraram sua qualidade vocal normal, frequência, intensidade de voz e velocidade de fala regulares, além de voz expressiva. Com relação aos recursos comunicativos, houve baixa ocorrência de regionalismo, de uso de gestos e de recursos de apoio nas vendas e alta ocorrência de articulação precisa dos sons da fala, de contato visual, de desinibição na comunicação, de controle do tempo e de objetividade do discurso. Conclusão Representantes de vendas autoavaliaram de forma positiva a objetividade no discurso, o domínio do assunto e o uso de vocabulário adequado e de forma negativa a falta de domínio do assunto, as críticas e os preconceitos e o uso de vocabulário inadequado. Os grupos A e B se autoavaliaram de forma semelhante.

ABSTRACT Purpose To analyze the self-assessment of communication resources used by sales representatives and its relation with their sales performance. Methods The study counted with 55 sales representatives, 46 men and 9 women, between 24 and 56 years old. In the first phase of the study, participants answered questions related to identification data, self-assessment protocols of vocal behavior and communicative resources; besides that, they were asked to select the positive and negative communication resources of their own speech during the sales. In the next phase, the participants were divided into two groups according to their sales performance: Group A (GA), individuals with better sales performance and Group B (GB), individuals with worst sales performance. The data were statistically analyzed. Results Regarding the vocal behavior self-assessment, the sales representatives considered their voice quality as normal, their vocal pitch, loudness and speech rate as regular and as having an expressive voice. Regarding the communicative behavior, there was low presence of regionalism, use of gesture and use of other support resources during the sales; contrarily, there was high occurrence of precise articulation of speech sounds, visual contact, lack of inhibition to talk, time monitoring and objectivity of the speech. Conclusion The sales representatives' self-assessment was positive for the objectivity of the speech, knowledge of the subject and use of proper vocabulary; it was negative for, lack of subject domain, criticism and prejudgment, and improper vocabulary. The self-assessment was similar in GA and GB.

Voice Self-assessment Protocols: Different Trends Among Organic and Behavioral Dysphonias.

OBJECTIVES: This study aimed to correlate the results of five self-assessment instruments for patients with behavioral or organic dysphonia (OD), and to analyze their relationship with listeners' judgments of degree of voice severity and predominant type of voice deviation. STUDY DESIGN: This is a cross-sectional prospective study. METHODS: A total of 103 patients (77 with behavioral dysphonia, 26 with OD) completed the Brazilian validated versions of five instruments: Voice Handicap Index (VHI), Voice-Related Quality of Life, Vocal Performance Questionnaire, Voice Symptom Scale (VoiSS), and Vocal Tract Discomfort Scale. Voice samples were collected for auditory-perceptual analysis. Correlations were made among protocols, and between these instruments and the perceptual analysis. RESULTS: None of the instruments correctly identified 100% of the dysphonic individuals. The VoiSS identified 100 of the 103 subjects. Numerous correlations were found with variable strength. The strongest correlation was between frequency and severity scales of the Vocal Tract Discomfort Scale (r = 0.946) and the total score of the VHI and VoiSS (r = 0.917). Correlations between the instruments and the perceptual analysis achieved only moderate strength; the VHI, the Voice-Related Quality of Life, and the VoiSS showed the highest correlations with counting numbers task, particularly for OD. The predominant type of voice deviation did not influence the score of the protocols. CONCLUSIONS: None of the self-assessment instruments is capable of identifying all cases of dysphonia. However, they are important in assessing the impact of voice problem on quality of life. Patient self-assessment and clinician perceptual evaluation share only moderate correlations, with higher strength for counting numbers task in comparison with sustained vowel.

Efficiency and Cutoff Values of Self-Assessment Instruments on the Impact of a Voice Problem.

OBJECTIVES: To evaluate the efficiency of four self-assessment questionnaires that rate the impact of a voice problem on the individual's life: Voice-Related Quality of Life (V-RQOL), the original and reduced versions of the Voice Handicap Index (VHI) and VHI-10, Vocal Performance Questionnaire (VPQ), and Voice Symptom Scale (VoiSS). METHODS: Data from 975 subjects, 486 with a diagnosis of dysphonia and 489 vocally healthy individuals, were submitted to the receiver operating characteristic (ROC) curve analysis to obtain the cutoff values that determine the discriminating power of these instruments (presence of dysphonia vs healthy voice). RESULTS: The ROC curve analysis showed that the most efficient questionnaires were the VoiSS and the VHI. Results showed that they presented as a perfect classification based on their efficiency, specificity, and sensitivity values (all three of them = 1). The VHI-10 and the V-RQOL showed excellent classification (VHI-10: efficiency = 0.991; specificity = 1; sensitivity = 0.981; V-RQOL: efficiency = 0.914; specificity = 0.860; sensitivity = 0.967). Finally, the VPQ showed a good level of classification (efficiency = 0.828; specificity = 0.824; sensitivity = 0.831). The cutoff values for the instruments are as follows: VoiSS = 16 points, VHI = 19 points, VHI-10 = 7.5 points, V-RQOL = 91.25, and VPQ = 20.5 points. These values are important for screening large populations as well as for helping in the decision-making process of clinical management. The cutoff values for maximum sensitivity and specificity of the instruments that did not produce perfect classification are as follows: VHI-10: sensitivity = 5; specificity = 7.5, V-RQOL: sensitivity = 86.25; specificity = 98.75, and VPQ: sensitivity = 15.5; specificity = 31.5. CONCLUSIONS: Both the VoiSS and the VHI are perfect classifiers. The VHI-10 and the V-RQOL are excellent classifiers, and the VPQ is good at discriminating individuals with dysphonia from the ones without dysphonia.

Voice symptoms and vocal deviation self-assessment in different types of dysphonia.

PURPOSE: To identify the relationship among the type of dysphonia, vocal deviation self-assessed and the presence of voice symptoms in adults. METHODS: One hundred sixty-four subjects of both genders (58 males and 106 females, mean age 42.89 years) diagnosis of dysphonia, divided into three groups according to the type of dysphonia: 87 individuals with functional dysphonia, 35 individuals with organofunctional dysphonia and 42 individuals with organic dysphonia, answered the Brazilian validated version of Voice Symptom Scale (VoiSS) (Escala de Sintomas Vocais - ESV), that consists of 30 questions with four scores: Impairment, Emotional, Physical and Total, and self-assessed their voices as excellent, very good, good, fair or poor. RESULTS: According to the dysphonia type, there were differences in ESV Impairment, Emotional and Total mean scores, which was not found in the Physical score. The Impairment, Emotional and Total mean scores were higher in organic dysphonia, followed by organofunctional dysphonia and finally functional dysphonia. When the vocal self-assessment is poor, the higher are the deviations in the Impairment, Emotional and Total ESV scores. CONCLUSIONS: Individuals with organic dysphonia reported higher perception of voice symptoms, followed by subjects with organofunctional dysphonia and finally individuals with functional dysphonia. In general, individuals with dysphonia presented physical voice symptoms, regardless of the type of the dysphonia. Finally, there are direct correlations between Impairment, Emotional and Total ESV scores and the vocal self-assessment.

Desconforto vocal em indivíduos com queixa cervical: uma abordagem baseada em questionários de autoavaliação / Vocal discomfort in individuals with cervical complaints: an approach based onself-assessment questionnaires

Objetivo Verificar a relação entre a ocorrência de desconforto vocal e queixa cervical, a partir de questionários de autoavaliação. Métodos Trinta indivíduos de 18 a 65 anos de idade, todos com algum tipo de queixa cervical, responderam à versão traduzida e adaptada culturalmente do questionário de autoavaliação cervical The Copenhagen Neck Functional Disability Scale (CNFDS) - denominado em português Escala Funcional de Incapacidade do Pescoço de Copenhagen (EFIPC) - e dois instrumentos de autoavaliação vocal: o Questionário de Qualidade de Vida e Voz (QVV) e a Escala de Desconforto do Trato Vocal (EDTV). Testes estatísticos foram aplicados para analisar a possibilidade de relação entre os dados obtidos. Resultados A maioria dos participantes referiu presença de desconforto vocal, sendo que quase metade deles apresentou relevante quantidade de sintomas desse desconforto. Dentre esses, a secura foi referida com maior frequência e a coceira, o sintoma que apresentou maior intensidade. Não houve correlação entre o EFIPC e o QVV ou o EDTV. Houve correlação negativa entre QVV e EDTV. Conclusão Apesar dos participantes apresentarem ocorrência elevada de desconforto vocal não houve correlação entre os questionários escolhidos. .

Purpose To verify the relationship between the occurrence of vocal discomfort and cervical complaints by using self-assessment questionnaires. Methods Thirty individuals (18–65 years of age) with various cervical complaints answered a translated and culturally adapted version of the self-assessment cervical questionnaire, The Copenhagen Neck Functional Disability Scale (CNFDS), titled Escala Funcional de Incapacidade do Pescoço de Copenhagen (EFIPC), the vocal self-assessment instruments Voice-Related Quality of Life (V-RQOL), and the Vocal Tract Discomfort Scale (VTDS). Statistical tests were used to analyze the possible relationships between the data obtained. Results Most of the participants reported the presence of vocal discomfort, with almost half presenting with a significant number of vocal discomfort symptoms; among these symptoms, dryness was reported most frequently and itching was reported with the highest intensity. No correlation was found between the EFIPC and V-RQOL or VTDS findings, but a negative correlation was found between the V-RQOL and VTDS findings. Conclusion Although the participants reported a high occurrence of vocal discomfort, no correlation was found between the selected questionnaires. .

Cross-cultural adaptation of the Brazilian version of the Eating Assessment Tool - EAT-10 / Equivalencia cultural da versao brasileira do Eating Assessment Tool - EAT-10

The Eating Assessment Tool (EAT-10) was conceptually developed in the United States from data collected from 482 patients, for use as a self-administered survey regarding risk identification of dysphagia and symptoms related to clinical response to treatment. The purpose of this study is to present the cultural equivalence of the Brazilian version of the EAT-10. The process followed the Scientific Advisory Committee of Medical Outcome Trust (SACMOT). The questionnaire was translated by two Brazilian bilingual speech-language pathologists, aware of the purpose of this study. A back translation was performed by a third Brazilian speech-language pathologist, bilingual and English teacher that had not participated in the previous stage. After comparing both translations, a final version of the questionnaire was produced and called Instrumento de Autoavaliação da Alimentação (EAT-10). It was administered to 107 adult inpatients of the Hospital São Paulo, cwith request for bedside clinical evaluation of swallow. During the process of translation and cultural adaptation, no item was modified and/or suppressed. The EAT-10 maintained the same structure as the original American English version with ten questions, of which three of functional domain, three of emotional domain and four of physical symptoms domain. The cultural equivalence of the Brazilian version of the EAT-10 was demonstrated, being a score of three points or above it the cutoff for dysphagia risk, also for the Brazilian population.

O Eating Assessment Tool (EAT-10) foi conceitualmente desenvolvido nos Estados Unidos da América, a partir de informações de 482 pacientes, para o uso como instrumento de autoavaliação do risco de disfagia e de sintomas para evidenciar respostas clínicas ao tratamento. O objetivo deste estudo é apresentar a equivalência cultural da versão brasileira do EAT-10. O processo seguiu as recomendações do Scientific Advisory Committee of Medical Outcome Trust (SACMOT). O questionário foi traduzido para a língua portuguesa por duas fonoaudiólogas brasileiras bilíngues, cientes do objetivo desta pesquisa. Uma retrotradução foi efetuada por uma terceira fonoaudióloga brasileira, bilíngue e professora de inglês, não participante da etapa anterior. Após comparação das traduções, produziu-se uma única versão traduzida denominada Instrumento de Autoavaliação da Alimentação (EAT-10), aplicada em um grupo de 107 indivíduos adultos, internados no Hospital São Paulo, com solicitação de avaliação clínica fonoaudiológica da deglutição. No processo de tradução e adaptação cultural, não houve modificação e/ou eliminação de nenhuma questão. A composição do EAT-10 reflete a versão original do inglês, com dez questões, sendo três do domínio funcional, três do domínio emocional e quatro do domínio físico. Houve equivalência cultural do EAT-10 para o português brasileiro, sendo um escore de três ou mais pontos a nota de corte para risco de disfagia também na realidade nacional.

Singing voice handicap mapped by different self-assessment instruments / Desvantagem vocal no canto mapeado por diferentes protocolos de autoavaliacao

PURPOSE: To map voice handicap of popular singers with a general voice and two singing voice self-assessment questionnaires. METHODS: Fifty singers, 25 male and 25 female, 23 with vocal complaint and 27 without vocal complaint answered randomly the questionnaires. For the comparison of data, the following statistical tests were performed: Mann-Whitney, Friedman, Wilcoxon, Spearman and Correlation. RESULTS: Data showed that the VHI yielded a smaller handicap when compared to the other two questionnaires (VHI x S-VHI - p=0.001; VHI x MSVH - p=0.004). The S-VHI and MSVH produced similar results (p=0.723). Singers with vocal complaint had a VHI total score of 17.5. The other two instruments showed more deviated scores (S-VHI - 24.9; MSVH - 25.2). There was no relationship between gender and singing style with the handicap perceived. A weak negative correlation between the perceived handicap and the time of singing experience was found (-37.7 to -13.10%), that is, the smaller the time of singing experience, the greater the handicap is. CONCLUSION: The questionnaires developed for the assessment of singing voice, S-VHI and MSVH, showed to be more specific and correspondent to each other for the evaluation of vocal handicap in singers. Findings showed that the more the time of singer's singing experience, the smaller the handicap is. Gender and singing styles did not influence the perception of the handicap. .

OBJETIVO: Mapear desvantagens vocais em cantores populares por meio de protocolos de autoavaliação: um genérico (IDV) e outros dois específicos para canto (IDV-C e IDCM). MÉTODOS: Cinquenta cantores, 25 de cada gênero, 23 com queixa vocal e 27 sem queixa vocal responderam aos 3 protocolos, apresentados em ordem casual. Para a comparação dos resultados, foram utilizados os testes estatísticos: Mann-Whitney, Friedman, Wilcoxon, Spearman e Correlação. RESULTADOS: Os resultados mostraram que o protocolo IDV aponta menor desvantagem que os protocolos específicos (IDV x IDV-C - p= 0,001; IDV x IDCM - p=0,004). O IDCM e IDV-C foram correspondentes e intercambiáveis em sua comparação (p=0,723). Os cantores com queixa apresentaram um escore total para o IDV de 17,5. Os outros protocolos apresentaram valores mais desviados IDV-C - 24,9 e IDCM - 25,2. Não foi verificada influência do gênero e de estilo de canto na percepção da desvantagem vocal em nenhum dos protocolos. Uma fraca correlação entre a desvantagem percebida e o tempo de canto foi encontrada (-37,7 para -13,10%), sendo que quanto menor a prática no canto, maior a desvantagem referida. CONCLUSÃO: O IDCM e o IDV-C mostraram-se mais específicos e são similares na avaliação de cantores. Quanto maior o tempo de experiência do cantor, menor é sua desvantagem. O gênero e o número de estilos de canto não influenciaram a percepção da desvantagem vocal. .